The End

Yesterday was my final day of treatment. I suppose that makes today the proverbial first day of the rest of my life.

My feelings continue to be mixed, rather amazingly so. I mean, I just came through the hardest 7 weeks of my life, by a long shot, and I should be deliriously happy, right? It’s more complicated than that, though.

I have much to celebrate, to be certain. My radiation oncologist told us yesterday that there is a “99.99% chance” my 3 month CT will be clear (I do not think that was based on a close reading of the literature, but I will take it!). I came through this treatment without any medically-induced disasters. In fact, almost everything went according to plan. The sole exception was the failure of my once-reliable veins to hold up to these vein-irritating medicines; after the week 3 infusion required 3 tries to start my IV, and the next week 4 tries, we agreed to thread in a PICC line via my right upper arm to allow large vein access near my heart. I only needed it for 12 days, and while it was a bit of a drag (tubes dangling out of my arm, caution with showers, my first ever cardiac arrhythmias, especially when I lay on my right side), truly it was a mere blip on this journey. Overall, the massive advantage of starting this process as a fit 53 year old with healthy habits, coupled with a savvy care plan and perhaps a bit of good luck, set me up well to get through this process mostly intact.

Why, then, am I not feeling more celebratory? I suppose it comes back to my mouth. My oral symptoms have been bouncing around their peak all week, and may well get worse this next week or two before starting to stabilize. That’s rather daunting. As it is, most days my tongue hurts too much to be able or willing to talk much beyond a whisper, secretions ooze from my injured epithelium at an alarming rate, drinking fluids is unpleasant, and eating solids is a slow, sweat-inducing grind. My taste buds are largely off-line; I was jealously watching my older daughter enjoy the alluring cherries I had brought home recently when she offered I should try one. I did. It tasted like… nothing.

I am so ready for my life to be a bowl of cherries! It’s the strangest of sensations. For anyone who has known depression, one of the worst aspects is the hopelessness that is one of its defining traits; there is no sense that climbing out of this valley is even possible. In this setting, however, I am almost certain I can and will have my usual joie de vivre back intact, probably just in a matter of weeks. My mission in life has been re-charged; my appreciation now palpable for the incredible love and support I receive in this lifetime; and the relaxed nature that comes with a sense of living out a second chance already seeps into my interactions. The ability of my raw mouth to trump all these blessings astounds me.

There, too, lies a lesson for my physician self. Every medical office has its “hard” patients — the ones who ask a little more, give a little less courtesy, always want to be at the front of the line. Occasionally, these are healthy people with hard personalities; usually, though, a “raw mouth” sits behind their needs — anxiety, chronic illness, disability, progressive disease, pain. Because most patients are so incredibly thoughtful and understanding of how hard running a medical office can be, we tend to vilify these “difficult” patients. “Why can’t they just be happy with what we are doing like everyone else?” I’m beginning to understand now. Couple that proverbial raw mouth with an unsupportive home environment or frank loneliness, or add anxiety that something terrible or irreversible could be progressing undetected, and it’s fair to lose one’s equanimity; maybe even basic good manners, too.

It helps me to write and reflect on these matters. My uncomfortable mouth, put in perspective, bothers me less already. While this may be The End of the destructive phase of my cancer treatment, I will keep writing a while longer. A few more chapters to which I still don’t know the ending await.